Margo Muniz, M.D. OB/GYN
Bring quality back to your life.
Am I the Only One? Pelvic floor conditions are more common than hypertension, depression, or diabetes. One in three adult women have hypertension; one in twenty adult women have depression; one in ten adult women have diabetes; and, more than one in two adult women suffer from pelvic floor dysfunction.
Let’s Start at the Beginning. This is the Female Pelvis.
The muscles naturally support the Bladder, Uterus and Bowel.
This important network of muscles perform a variety of important tasks such as supporting vital organs like the bladder and large intestines. In women, the pelvic floor also has the additional responsibility of supporting the vagina, thereby supporting the uterus.
And Then Comes Baby…
Before… And After.
What problems can arise from weakened or injured pelvic floor muscles? A healthy pelvic floor keeps the pelvic organs in their proper place and the muscles that close the bladder and anus functioning normally. With a weakened pelvic floor, the uterus or other organs may sag (prolapse).
Weakness and injury also make it more difficult for the bladder muscle to stay closed during sudden increases in abdominal pressure, such as while coughing, laughing, sneezing, or lifting a heavy object. This can result in leaking urine (urinary stress incontinence).
Finally, injury to the band of muscle around the anus can result in leaking gas, a sense of urgency about elimination, or, less commonly, leaking feces.
What Other Factors Can Cause Pelvic Floor Dysfunction?
Sometimes excess weight can cause stress incontinence.
Other risks include: • Smoking • Genetics • White Race • Vaginal Atrophy • Spinal Injury • Hysterectomy
How would I know if I have Organ Prolapse?
Prolapse Organs could be: • Bladder • Urethra • Uterus • Vagina • Small Bowel • Rectum
Symptoms Would be: • A feeling of heaviness or pressure in the pelvis. • Pain in the pelvis, abdomen or lower back. • Pain during intercourse. • A protrusion of tissue from the opening of the vagina. • Recurrent bladder infections. • Unusual or excessive discharge from the vagina. • Constipation. • Difficulty with urination, including involuntary loss of urine (incontinence), or urinary frequency or urgency.
What Can I Do About This? • Do Kegel Exercises Stick to a Schedule • • Timed Urination helps keep the bladder empty. • Fill the Void Don’t be in a hurry! Empty your bladder, wait a few minutes and • empty it again. Keep the Path Clear • • Clear the path to the restroom and wear easy-off clothing. • Reduce Caffeine Drink up – but Not Too Much • • Stay hydrated, but don’t overdo it on the liquids.
But What About Long Term? • Talk to Your Doctor • Change Your Diet • Manage your fluids. • Lose Weight • Quit Smoking • Choose Medication or Surgery
What Are My Options? Non-Surgical: Kegel Exercises • Reach a Healthy Weight • • Avoid Heavy Lifting Being fitted with a Pessary •
What Are My Options? Surgical: Surgery to repair the tissue that supports a prolapsed • organ. • Surgery to repair the tissue around your vagina. • Surgery to close the opening of your vagina. • Surgery to remove the uterus (Hysterectomy).
What Are My Options? Advanced/Alternative: Biofeedback • Non-Traditional Medical Therapies • • Intra-Vesical Botox • External Support Devices
What Are My Options? Advanced/Alternative: Urethral Dilation • Urethral Collagen • • Neuromodulators
What Are My Options? Advanced/Alternative: Neuromodulators •
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